|
Abdominal CT scan (with and without contrast)
|
$8,528.64 |
$8,528.64 |
$8,528.64 |
$2,049.00
|
|
Abdominal CT scan (with contrast)
|
$6,526.92 |
$6,526.92 |
$6,526.92 |
$1,683.63
|
|
Abdominal CT scan (without contrast)
|
$5,615.40 |
$5,615.40 |
$5,615.40 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$9,720.98 |
$9,720.98 |
$9,720.98 |
$2,916.21
|
|
Abdominal MRI (without contrast)
|
$4,056.83 |
$4,056.83 |
$4,056.83 |
$1,972.66
|
|
Abdominal paracentesis w/image guidance
|
$11,705.16 |
$11,705.16 |
$11,705.16 |
$1,666.30
|
|
Abdominal Ultrasound (complete)
|
$2,803.23 |
$2,803.23 |
$2,803.23 |
$759.57
|
|
Abdominal Ultrasound (limited)
|
$2,369.66 |
$2,369.66 |
$2,369.66 |
$603.33
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$287.87 |
$287.87 |
$287.87 |
$125.63
|
|
Acetaminophen level
|
$237.35 |
$237.35 |
$237.35 |
$117.01
|
|
Acetazolamide 500 mg solution for injection
|
$498.34 |
$498.34 |
$498.34 |
$133.60
|
|
Acetone qualitative
|
$106.98 |
$106.98 |
$106.98 |
$47.45
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$213.93 |
$213.93 |
$213.93 |
$323.77
|
|
Acute hepatitis panel
|
$503.61 |
$503.61 |
$503.61 |
$284.70
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$97.22 |
$97.22 |
$97.22 |
$50.70
|
|
Adenosine 3 mg/250 ml bag for osm
|
$1,575.82 |
$1,575.82 |
$1,575.82 |
$219.86
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$79.21 |
$79.21 |
$79.21 |
$124.70
|
|
Administration immunization 1 vaccine
|
$198.47 |
$198.47 |
$198.47 |
$70.52
|
|
Administration immunization each additional vaccine
|
$136.31 |
$136.31 |
$136.31 |
$46.23
|
|
Administration vaccine influenza virus
|
$1,165.65 |
$1,165.65 |
$1,165.65 |
$49.50
|
|
Albumin (human), 25%, 50ml
|
$4,124.83 |
$4,124.83 |
$4,124.83 |
$295.80
|
|
Albumin, human 25 % intravenous solution
|
$1,522.05 |
$1,522.05 |
$1,522.05 |
$488.08
|
|
Albumin (human), 5%, 250 ml
|
$2,451.49 |
$2,451.49 |
$2,451.49 |
$295.80
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$190.38 |
$190.38 |
$190.38 |
$57.60
|
|
Albumin serum plasma or whole blood
|
$141.61 |
$141.61 |
$141.61 |
$43.50
|
|
Albuterol ipratrop non-comp
|
$49.07 |
$49.07 |
$49.07 |
$22.45
|
|
Albuterol non-comp unit
|
$11.93 |
$11.93 |
$11.93 |
$9.59
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$657.37 |
$657.37 |
$657.37 |
$93.60
|
|
Alkaline phosphatase
|
$139.31 |
$139.31 |
$139.31 |
$46.20
|
|
Allergen alpha lactalbumin ige
|
$62.27 |
$62.27 |
$62.27 |
$56.35
|
|
Allergen egg white ige
|
$66.47 |
$66.47 |
$66.47 |
$41.00
|
|
Alpha-fetoprotein tumor marker
|
$87.27 |
$87.27 |
$87.27 |
$99.00
|
|
Alteplase 100 mg infusion from pyxis vial
|
$1,583.73 |
$1,583.73 |
$1,583.73 |
$2,600.22
|
|
Alt/sgpt
|
$67.49 |
$67.49 |
$67.49 |
$49.00
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$70.27 |
$70.27 |
$70.27 |
$41.59
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$941.93 |
$941.93 |
$941.93 |
$202.10
|
|
Amiodarone 50 mg/ml intravenous solution
|
$165.72 |
$165.72 |
$165.72 |
$47.44
|
|
Amitriptyline (elavil) -sendout
|
$343.29 |
$343.29 |
$343.29 |
$101.17
|
|
Amivantamab-vmjw 50 mg/ml intravenous solution
|
$37,234.76 |
$37,234.76 |
$37,234.76 |
$15,167.75
|
|
Ammonia
|
$226.58 |
$226.58 |
$226.58 |
$120.90
|
|
Ampicillin 1 gram solution for injection
|
$202.93 |
$202.93 |
$202.93 |
$57.76
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$418.81 |
$418.81 |
$418.81 |
$51.93
|
|
Amplification real-time pcr dna markers infectious disease bacterial vaginosis and vaginitis
|
$788.97 |
$788.97 |
$788.97 |
$312.00
|
|
Amylase
|
$199.67 |
$199.67 |
$199.67 |
$93.00
|
|
Analysis gene f2 20210g>a variant
|
$836.49 |
$836.49 |
$836.49 |
$219.60
|
|
Analysis gene f5 leiden variant
|
$934.28 |
$934.28 |
$934.28 |
$226.60
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$14,669.95 |
$14,669.95 |
$14,669.95 |
$6,736.02
|
|
Ankle X-ray
|
$1,493.47 |
$1,493.47 |
$1,493.47 |
$339.44
|
|
Anodyne therapy charges pt
|
$114.59 |
$114.59 |
$114.59 |
$41.02
|
|
Antibody elution rbc reference
|
$455.16 |
$455.16 |
$455.16 |
$176.54
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$233.92 |
$233.92 |
$233.92 |
$220.73
|
|
Antibody id rbc panel
|
$915.98 |
$915.98 |
$915.98 |
$291.75
|
|
Antibody screen rbc
|
$234.90 |
$234.90 |
$234.90 |
$105.00
|
|
Anti mog serum - sendout
|
$39.86 |
$39.86 |
$39.86 |
$140.62
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$153.45 |
$153.45 |
$153.45 |
$50.88
|
|
Antineutrophil cytoplasmic antibody titer each antibody
|
$153.45 |
$153.45 |
$153.45 |
$45.82
|
|
Antinuclear antibodies
|
$41.98 |
$41.98 |
$41.98 |
$91.70
|
|
Antinuclear antibodies titer
|
$142.12 |
$142.12 |
$142.12 |
$80.25
|
|
Antiphosphatidylserine antibody
|
$142.68 |
$142.68 |
$142.68 |
$74.20
|
|
Antistreptolysin o screen
|
$18.18 |
$18.18 |
$18.18 |
$59.40
|
|
Antistreptolysin o titer
|
$231.72 |
$231.72 |
$231.72 |
$57.96
|
|
Antithrombin iii activity
|
$41.16 |
$41.16 |
$41.16 |
$115.23
|
|
Application finger splntstatic 29130
|
$1,792.70 |
$1,792.70 |
$1,792.70 |
$216.80
|
|
Application long leg splint 29505
|
$2,494.22 |
$2,494.22 |
$2,494.22 |
$340.80
|
|
Application lower leg splint 29515
|
$2,494.22 |
$2,494.22 |
$2,494.22 |
$355.85
|
|
Application of forearm cast 29075
|
$4,261.57 |
$4,261.57 |
$4,261.57 |
$379.20
|
|
Application of long arm cast 29065
|
$776.96 |
$776.96 |
$776.96 |
$404.63
|
|
Application short leg cast 29405
|
$4,261.57 |
$4,261.57 |
$4,261.57 |
$393.98
|
|
Apply finger cast 29086
|
$2,494.22 |
$2,494.22 |
$2,494.22 |
$225.29
|
|
Apply intrcav radiat compl
|
$4,470.33 |
$4,470.33 |
$4,470.33 |
$1,717.51
|
|
Apply intrcav radiat interm
|
$3,716.73 |
$3,716.73 |
$3,716.73 |
$1,338.48
|
|
Apply intrcav radiat simple
|
$2,507.42 |
$2,507.42 |
$2,507.42 |
$1,001.00
|
|
Aprepitant 130 mg/18 ml (7.2 mg/ml) intravenous emulsion
|
$2,407.15 |
$2,407.15 |
$2,407.15 |
$943.40
|
|
Aqua therapy w/exercise/ea 15 min 97113
|
$198.95 |
$198.95 |
$198.95 |
$98.90
|
|
Aquatic exercise - group charge
|
$113.76 |
$113.76 |
$113.76 |
$87.60
|
|
Arsenic trioxide 2 mg/ml intravenous solution
|
$843.44 |
$843.44 |
$843.44 |
$1,303.25
|
|
Arthrocentesis/aspiration/injection intermediate joint/bursa without ultrasound guidance right
|
$1,945.68 |
$1,945.68 |
$1,945.68 |
$567.78
|
|
Arthrocentesis/aspiration/inj major joint/bursa without Ultrasound guidance (both sides)
|
$808.98 |
$808.98 |
$808.98 |
$698.58
|
|
Aspirate pleura without imaging 32554
|
$9,045.97 |
$9,045.97 |
$9,045.97 |
$1,249.21
|
|
Assay dir meas fr estradiol
|
$92.41 |
$92.41 |
$92.41 |
$76.80
|
|
Assay of interleukin-6 (il-6)
|
$219.91 |
$219.91 |
$219.91 |
$77.35
|
|
Assay of salicylate
|
$315.00 |
$315.00 |
$315.00 |
$105.95
|
|
Assess aphasia/interp/rpt/per hr 96105
|
$654.29 |
$654.29 |
$654.29 |
$312.00
|
|
Assessment leukocyte fecal qualitative/semiquantitative
|
$217.67 |
$217.67 |
$217.67 |
$49.80
|
|
Ast/sgot
|
$65.96 |
$65.96 |
$65.96 |
$45.65
|
|
Atezolizumab 60 mg/ml intravenous solution (wrapper)
|
$36,509.35 |
$36,509.35 |
$36,509.35 |
$31,208.35
|
|
Atropine 0.1 mg/ml injection syringe
|
$166.35 |
$166.35 |
$166.35 |
$43.01
|
|
Avulsion nail plate partial/complete simple single nail plate
|
$556.37 |
$556.37 |
$556.37 |
$342.55
|
|
Azacitidine injection
|
$509.20 |
$509.20 |
$509.20 |
$912.29
|
|
Azithromycin 500 mg intravenous solution
|
$155.57 |
$155.57 |
$155.57 |
$52.69
|
|
Baclofen eval charges
|
$109.06 |
$109.06 |
$109.06 |
$86.14
|
|
Bacterial meningitis antigen
|
$146.95 |
$146.95 |
$146.95 |
$68.40
|
|
Bacterial vaginosis pcr
|
$893.92 |
$893.92 |
$893.92 |
$298.04
|
|
#bac vag cand-c. albicans naa
|
$446.83 |
$446.83 |
$446.83 |
$112.80
|
|
Bendamustine 25 mg/ml intravenous solution (bendeka)
|
$10,533.66 |
$10,533.66 |
$10,533.66 |
$6,720.38
|
|
Benztropine 1 mg/ml injection solution
|
$194.68 |
$194.68 |
$194.68 |
$121.88
|
|
Beta 2 glycoprotein 1 antibody iga
|
$324.08 |
$324.08 |
$324.08 |
$97.21
|
|
Beta-2 microglobulin
|
$206.03 |
$206.03 |
$206.03 |
$84.66
|
|
Betamethasone acetate and sodium phos 6 mg/ml suspension for injection
|
$201.46 |
$201.46 |
$201.46 |
$75.12
|
|
Bevacizumab 25 mg/ml intravenous solution
|
$11,109.76 |
$11,109.76 |
$11,109.76 |
$4,905.00
|